Community Physiotherapy - South Sefton

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COVID-19 Service Update

Dear parents,

We have had to make some important changes to our service provision, due to current COVID 19 restrictions.

Telephone and video consultations - All follow up appointments are now done via telephone or video consultations. A therapist from our team will contact you to discuss your child’s therapy management plan. We can send exercise plans and advice to you via email.

New referrals - All new referrals are triaged and will receive a telephone consultation.

Critical Service Provision

This service is in place for a small cohort of patients identified to be in need of urgent respiratory input and risk of acute deterioration.

This category will also include any new referrals identified as critical following telephone consultation, post-operative patients and any sudden acquired impairments/ trauma.

We aim to provide these children with:

Teaching / training for self-management

Prophylactic (preventative) intervention (if identified as ‘at risk’)

Active intervention / input for symptoms as necessary.

Contact details

We would like to assure all of our patients and families that you can contact us for any queries by calling our office as normal, you may have to leave a message but these are regularly checked and we will get back to you.

We would love to hear how our children are getting on with their home exercise programs.

You can follow community physio on Twitter @south_seftonpt @AHNorthSefton

Additional Information

Please note that other departments like orthotics and wheelchair services are also changing their service provision. We advise you to ring them in advance, to discuss repair / provision as necessary. Contact numbers can be found below:

The South Sefton Paediatric Physiotherapy service is a team of specialist physiotherapists and assistants with the passion, experience and commitment to achieve the best possible outcomes for families and children in our care.

We have years of experience and expertise in helping our families to manage neurodisability (conditions affecting children’s development). It is important to us that this, combined with our friendly and caring approach, means that you can be confident that the treatment provided is of the highest quality. Every family we see is unique, each with their own challenges and aspirations. We will work with you as a team to plan how we can best help you to achieve your goals.

Who do we see?

Primarily we see children with neurodevelopmental problems and neurodisabilties. This involves providing specialist physiotherapy treatment for children between 0 and 19 years with conditions such as Cerebral Palsy, Developmental Delay, Muscular Dystrophy, Developmental Coordination Disorder (DCD) and other lifelong conditions.

We have experienced paediatric physiotherapists who can offer a variety of treatment options for the best possible outcome. Paediatric physiotherapy can provide numerous benefits:

Improved function

Improved balance

Increased muscle strength

Increased joint range of movement

Progression of developmental milestones

Normal movement re-education

Regain independence

Help to reduce contracture and deformity

Physiotherapy is an excellent way of maximising a child’s abilities and gaining a sense of independence. For more information on paediatric physiotherapy, please call our team on 0151 252 5729.

How we work: Information about appointments

We firmly believe that physiotherapy should be patient centred. This means your problems and goals are of paramount importance to us. We want to give you the best available service as quickly as we can and at a place and times that best meets your child’s needs.

Getting the most from your treatment

We believe the first step in helping you and your child is to understand your concerns for your child . All our physios work hard to help you understand your child’s condition. Any treatments or exercises the physio uses will be clearly explained. We like questions and are always happy to explain. Our physiotherapy input is designed to produce the best possible result for our families.

Working with others

We pride ourselves on our strong working relationships with other professionals. These may be from health, education, social care or the voluntary sector. We work closely together to make life easier for you and try to ensure that services are seamless.

Beyond the symptoms (diagnosis)

All our physios perform a complete assessment that helps them to find the reasons behind your child’s developmental problems. We will then concentrate treatment on working with you to ensure that your child can have as full and active a social, family and school life as they are able.

Physios who care

At South Sefton Physio there are no Physio – Dinosaurs. All our physios continually update their skills keeping them great at what they do. Our physios are enthusiastic professionals that go the extra mile in supporting their families. We are committed to providing a high quality service that’s aims to improve the lives of the families in our care.

Meeting your needs

We do our best to provide you with what you are looking for. We offer flexible appointment times at a range of locations including our base at Sefton Carers Centre, schools, nursery and home visits where indicated. We also work closely with professionals from the health, education, social and voluntary care sectors.

Pre-school pool sessions

Sessions are currently being held at Everton Nursery School and Family Centre, on Wednesday mornings.

The aim of these sessions is to provide you and your child with practical and therapeutic dressing advice, also to provide you with the confidence to be able to take your child to a swimming pool

The centre also has a café and a sensory room that you can access before or after your session

Referral for these sessions can be made by your child’s physiotherapist or occupational therapist

If you would like further details please speak to your physiotherapist or occupational therapist

Jake’s Sensory World at Netherton Activity Centre

We offer two regular group sessions at Jake’s Sensory World for pre-school children who are known to physiotherapy. These are our Baby Sensory Session and our Toddler Motor Session.

A soft play area where your child can move, climb and explore in a safe environment

Our families really enjoy meeting at Jake’s. It’s a great opportunity to meet your physiotherapist who will provide advice on how to make the most of the facilities for your child. (It’s so good that the speech and occupational therapists have started to pop along too!)

Parents and children love getting together in a relaxing but stimulating environment. Some of our families visit Jake’s for Stay and Play sessions run by Aiming Higher or arrange to go along with friends independently. You can even book birthday parties there!

Development Conditional Disorder (DCD)

Developmental Coordination Disorder is a condition when children may have difficulties with balance, motor planning, gross motor skills(e.g. hopping, jumping) and fine motor skills(e.g. dressing, writing). When a child is referred to the service, they will be given an appointment for assessment at the physiotherapy department at the Sefton Carers Centre.

The assessment will include:

A history of the child’s development e.g. did they crawl before walking, how old were they when they walked?

Functional abilities e.g. can they ride a bicycle, use a scooter, go up and down a slide?

Child’s concerns

Parent’s concerns

School concerns

Assessment of muscle strength

Assessment of balance skills e.g. balance on one leg, walking heel to toe along a line

Assessment of gross motor skills e.g. jumping, hopping

Assessment of eye hand coordination e.g. throwing and catching

Assessment of bilateral integration – ability to move both sides of the body at the same time e.g. march on the spot and tap knee with opposite hand

Advice will be provided if needed, and may include

A home exercise programme to follow

Liaison with leisure services e.g. aiming high team

A block of physiotherapy treatment

Review date

A written report of the assessment will be sent to the referrer, parent/carer, G.P., school and any other professionals that may find it useful e.g. Paediatrician, O.T.

Physio and occupational therapy together

When a child is referred for a physio and occupational therapy assessment, they may be assessed in a joint clinic based at Sefton Carers Centre. Children who are receiving treatment from the physiotherapist and occupational therapist may also be offered a joint review based at Sefton Carers Centre.

More information age-related services

SPOT

Your child may be referred for a SPOT assessment if there are concerns about how their development is progressing. Health visitors, GPs or hospital consultants can refer to SPOT.

The SPOT is team is made up of therapists, who work closely together to provide assessment and treatment for children up to the age of 3 years old who may have developmental problems. They will also monitor progress and provide advice which you may find helpful.

This includes conditions such as Cerebral Palsy, or Down syndrome. Your child may not have a diagnosis, but may be delayed in one or more areas of their development.

The physiotherapists who work in SPOT are specially trained and very experienced in treating babies and toddlers. In the SPOT team there is also a speech and language therapist who looks at communication and feeding and an occupational therapist who looks at play, hand function and equipment needs.

Our physiotherapist will assess your child’s gross motor skills i.e. ability to sit, stand, walk and move. We will work with you to provide ongoing treatment or we may monitor progress and provide advice that we think will help your child.

SPOT clinics

These usually take place on Mondays at Sefton Carers Centre. Newly referred children between the ages of 0-3 years old can be seen at this informal clinic where we will meet you and gain an understanding of your child's needs.

This assessment includes the use of the Bayley Infant Neurodevelopmental Screener, which helps us to check if your child has any neurological problems or developmental delay. This involves us using a range of play based activities.

At this appointment we are happy to discuss any concerns or worries you may have regarding your child’s development, and will agree with you a clear plan to meet your child’s therapy needs for the next six months. With your permission we may also refer your child onto other services such as the Community Paediatrician or Portage; we will always discuss this with you and explain why we think that this may be helpful for you and your child.

We will write a short report outlining our findings and confirming our discussion and plan; this is sent to yourselves and (with your consent) those involved in your child’s care.

SPOT review

We may invite you and your child back to a SPOT review clinic after approximately six months to check how your child is progressing and if you are happy with the input they are getting

We like to work closely with the other people involved in your child’s care, e.g. health visitor or portage worker. We usually invite them to this appointment so that we can try to ensure that we are all working together to make sure that your child gets the best possible care

Again we will write a short report outlining your child’s progress and updated plan and send a copy to yourselves and those involved in your child’s care

Your child will be discharged from SPOT at 3 years of age, but will continue to receive any therapies they still require. Review appointments may still take place if needed, but these will be held in your child’s nursery.

Complex needs clinics and SPOT

The SPOT team work closely with the consultant for Neurodisability in the community. Your child may be invited to attend these clinics at Sefton Carers Centre.

My baby was born prematurely. Do they need physiotherapy?

Many babies born early make wonderful progress in their development and do not need much, if any, physiotherapy. A few babies do have difficulties with their early development, and early physiotherapy intervention has been shown to be helpful.

What is early intervention?

Your baby may be referred to physiotherapy as soon as they are discharged from hospital. This is nothing to be concerned about and does not necessarily mean that you child will have problems with their gross motor skills as they grow up

It may be that your baby had medical problems whilst they were in the neonatal unit, such as a bleed in their brain, or hydrocephalus. Premature babies are at more risk of such problems, and early intervention can be helpful in monitoring your baby to see if the problems they had in the neonatal unit have affected their development

To begin with your baby will need to be assessed. The physiotherapist who will see your child will be specially trained and experienced in working with premature babies

They may use a standardised assessment called the Alberta Infant Measurement Scale (AIMS) which checks your child’s physical development

If your baby is at risk from developmental delay, early intervention physiotherapy will be started to help with their motor development. This may be something as simple as how you hold your baby or how you play with them

Early intervention physiotherapy has been shown to be very helpful to premature babies. Short-term research shows that about three quarters of parents of premature babies feel that early intervention has been helpful to their families. Long-term research is still being done, but early studies show that children who have had early intervention do better in school, are held back less often in school, and have higher IQs

Your physiotherapist will also be there to support you and your family, and may refer onto other services (with your permission) should they be considered necessary e.g. a speech and language therapist who can help you to help your baby’s feeding if you are having difficulties with this

If your child has ongoing therapy needs from 2 or more therapists your physiotherapist will refer them to SPOT to ensure that their therapies are coordinatedPre-school Pool Sessions

Starting nursery school

If your child is already known to our service, their physiotherapy care will soon be transferred from the pre-school team to therapists who work in the mainstream primary schools in South Sefton and in Rowan Park School. Don’t worry, we will talk to you about this and make sure that your family get to meet your new physio before it’s time to change.

We work closely with SENISS (Special Education Needs Inclusion and Support Service) and your Occupational Therapist to set up Access Visits in the year before your child is due to start school. By doing this we hope to anticipate and iron out any obvious barriers to inclusion.

What will my physio do?

Your physiotherapist aims to protect your child’s body shape and structures and to develop gross motor skills and mobility, working towards maximum independence and inclusion in all areas of education and leisure.

Your physiotherapist will usually visit your child in school, however it is important that you’re involved and can participate in their physio . Sometimes we will ask to meet you in school, or we can arrange to see you at home or at our treatment base, whichever is more suitable.

We’ll work with the teacher and classroom assistant on the kinds of activities which will be helpful in school. We may also provide exercises and advice for PE. We support and train school staff in postural management, treatment programmes and the use of any equipment that may be needed.

Your child may be provided with specialist equipment such as standing frames and walking frames, specialist footwear and splints.

Often the Physio will work with the OT to ensure that therapy includes all areas of life and development.

As part of the multidisciplinary team the physiotherapist may also be asked to write a report as part of statutory assessment which is then used to draw up your child’s Educational and Health Care Plan (EHCP). This is usually for when your child is attending a special school if your child has any physical problems which impact on his/her ability to access the curriculum. At other times we will attend school reviews to contribute to Individual Education Plans and provide information and advice to schools.

Moving onto secondary school

In the year before your child is due to move from primary into secondary, we get together with SENISS to set up Access Visits, Life in secondary school is very different, this is a great opportunity for you to visit the school with us and identify any problems that may need addressing. By doing this we hope to ensure as smooth a transition as possible.

The visit usually involves a walk around the school so that any changes can be put in place to meet the needs of your child before they are due to start. Some examples may include leaving class earlier to avoid crowded corridors, or having a lunch pass to avoid having to stand in a queue.

What will my physio do?

Secondary age students with cerebral palsy are offered a review of their needs at the physiotherapy department, our base at the Sefton Carers Centre. The session includes:

A physical examination e.g. range of movement and muscle strength.

Discussion of any concerns.

Agreement of goals at the end of the session, discussed with student, parents and physiotherapist

Written report for parents, school, doctors and any other relevant professionals e.g. occupational therapist

If treatment is needed, appointments are offered at either the physiotherapy department at the Sefton Carers Centre, or in school if preferred (if there are adequate facilities for treatment).

The following secondary schools have a physiotherapy room:

Crosby High

Hillside High (no overhead tracking)

Holy Family Catholic High

Litherland High

Maghull High

St Michael’s CE High

These are equipped with overhead tracking, physiotherapy plinth, mats and other physiotherapy equipment for individuals. If you have any concerns between reviews, you can always contact your physiotherapist who will arrange to see you.

Meet the team

Carole Lovatt - Physiotherapy and Occupational Therapy Professional Lead

I’ve been a children’s physiotherapist since 1988 and worked for Alder Hey in the Community for most of that time! I have been managing the OT and Physiotherapy service in North and South Sefton since October 2017. My special interest is in babies and young children with Neurodisability. I’m Bobath* trained and have been the regional representative in the past. My Bobath membership and training opportunities have allowed me to train with and share experiences and knowledge with therapists from all over the world. I enjoy being a Manager and Therapist and work with a great team. My dual role enables me to help to shape a service that is modern and responsive to the needs of the families and children of Sefton.

*Bobath- an approach to assessment and treatment that is holistic and is based on neurorehabilitation in which the child actively participates in their therapy

Juliet Weston - Highly Specialist Paediatric Physiotherapist

I have been a children’s physiotherapist since 1991. I have worked for Alder Hey since 1993, initially in the hospital as part of the Head Injury Rehabilitation Team, and then in South Sefton community. My special interest is in babies and young children with Neurodisability. I also monitor the motor progress of babies born prematurely. I am Bobath Trained and completed an MSc in Health Practice in 2005. Keeping up to date with current practice is important to me and I regularly attend training courses and read up to date physiotherapy literature.

My work in South Sefton involves not only physiotherapy assessment and treatment; I also run a hydrotherapy group session for pre-school children and regular group therapy session at Jake’s Sensory World. I enjoy these sessions as they allow parents to meet each other and socialise.

Rosemary Turner- Highly Specialist Paediatric Physiotherapist

I started work with Alder Hey as part of the South Sefton Team in May 2000, after a break while my 4 children were young. Over this time I have seen the service develop as more children with long term neurological conditions move into mainstream schools. I enjoy working with all the agencies to ensure that barriers to inclusion are challenged and that children learn to look after their bodies whilst getting on with their school life.

I oversee equipment provision, working with Sefton’s Integrated Community Equipment Stores, to ensure timely and suitable provision. I like processes and audit so am also responsible for risk management, patient satisfaction and case note review.

Debbie Dryden - Highly Specialist Paediatric Physiotherapist

I joined the team in 2000, having previously worked in Scotland and New Zealand. I work in Rowan Park School with the more complex needs children. I have a specialist interest in hydrotherapy and have completed the Halliwick Association of Swimming Therapy course. I also take the lead with the orthotics service for our team, assessing for appliances and Lycra garments.

Hilary Finlay - Highly Specialist Paediatric Physiotherapist

I have been a physiotherapist since 1988, specialising in Paediatrics in 1991. I joined Alder Hey in 1993 where I gained experience on the wards and in the physiotherapy department in the acute setting. I transferred to the Community and worked in both mainstream and special schools in Liverpool treating children from 3-18 years. I spent 7 years gaining experience in assessment of children with movement disorders at the Gait laboratory at Alder Hey where children are assessed before surgery and other interventions.

I am now part of the South Sefton Team and work with pre-school children with Neurodisability as well as working with children at Rowan Park School. I am Bobath trained and have a keen interest in Neurodevelopment and Postural management.

Ruth Ade-Hall

I joined the team in June 2017 as a specialist children's physiotherapist after a career break to bring up my children. I mainly work with school-aged children and am responsible for assessing children with poor gross motor skills in clinic at Sefton Carers Centre.

Sara Deegan

I joined the team in September 2016 and my main place of work is Rowan Park School.

I have previously spent time working with children with a visual impairment for a Liverpool based charity. I have always been a keen member of the community, volunteering at the children’s centre as well as sitting on the board of governors at a local children’s nursery as Vice Chair since 2011.

I enjoy working at Rowan Park School, supporting the children, teachers and parents. No two days are ever the same, which I love!

Zoe Teage

I was delighted to join the team in September 2017. I have always loved working with children and am qualified as a NurseryNurse and Hospital Play Specialist. Previously I worked in a pre-school nursery with 2-4 year olds and also at Alder Hey hospital for 12 years, where I was based in the Emergency Department.

I am thrilled to be in a community based team and love working with the childrena and team!

Elaine Coughlan - Senior Physiotherapy Assistant

I am Senior Physio Assistant for the service. My main place of work is Rowan Park School, but I also go out and see children in mainstream schools. I work alongside Debbie to support hydrotherapy. I take the lead in managing the equipment we provide to children. I enjoy working with a great team and also the children, making sure their treatment is as enjoyable as possible.

Pam Usher - Team Secretary

I have been part of the team here since 2011, having previously worked across a couple of other NHS trusts. I am the first point of contact for the team, and will speak to all the parents at some point on the phone, but not always get to see everyone in person. I support the orthotics clinics which I enjoy because I get to meet the children and their families- putting a face to the names! I work term time only which fits in perfectly with my own young children.

Referrals to South Sefton Community Physiotherapy

If you have discussed your concerns with your GP, Health Visitor, School Nurse or one of the professionals involved with your child, you should ask them to fill in a referral form or write us a letter.